Antibiotic stewardship driver diagram and change package
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Antibiotic stewardship driver diagram and change package

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      Prepared by the Institute for Healthcare Improvement (IHI) Prepared for the Centers for Disease Control and Prevention (CDC)

      A Framework to Reduce Inappropriate Antibiotic Utilization in Hospitals: The Centers for Disease Control and Prevention (CDC) and the Institute for Healthcare Improvement (IHI) partnered in an effort to develop this conceptual model of key drivers for reducing inappropriate antibiotic utilization. Content experts contributed to the development of this robust driver diagram and change package with a recognition and emphasis on practicality and ease of implementation in all hospitals.

      Pilot Testing: From September 2011 to June 2012, CDC and IHI worked with eight hospitals on pilot testing the enclosed set of recommendations to assess the feasibility of implementation in hospitals of varying size, acuity, and location. The Driver Diagram and Change Package were modified based on that pilot testing.

      How to Use The Driver Diagram and Change Package: The Driver Diagram attempts to lay out the various processes that can lead to optimal antibiotic use. The broad categories of these processes are referred to as Primary and Secondary Drivers. The Change Package outlines a number of specific interventions that have either been demonstrated to or experts believe will positively impact the drivers. The ultimate goal is to use the interventions in the Change Package to “drive” improved antibiotic use.

      We do not recommend that any facilty attempt to implement all of the interventions at once. There are a large number of interventions outlined in the Change Package, and attempting to implement too many at one time will likely create huge challenges. Rather, the Change Package is meant to serve as a menu of options from which facilities can select specific inerventions to improve antibiotic use.

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